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Published on: February 23, 2024
A Comparative Evaluation of 2 Rapid Strategies for Visual Field Testing: SITA Faster and SPARK Quick
Xiaoyan Wang1, Xiaoqian Bian2, Yize Chen2
1Ningbo Eye Hospital, Wenzhou Medical University, Ningbo, Zhejiang, China.
Objective:
This study compares the diagnostic performance of 2 rapid visual field testing strategies, SITA Faster and SPARK Quick, against the "gold standard" SITA Standard. The measurement accuracy, agreement, and repeatability were evaluated.
Design:
A prospective, cross-sectional study.
Participants:
A total of 118 eyes of 118 participants were enrolled.
Methods:
Participants from a glaucoma clinic underwent multiple visual field tests. All subjects were naïve to SITA Faster and SPARK Quick, with SITA Standard 24-2 serving as the initial test. SITA Faster and SPARK Quick were then administered in random order. Among the 74 participants with visual field defects detected by SITA Standard, 49 underwent testing twice with both rapid strategies. Parameters were compared using one-way ANOVA with Bonferroni post hoc tests, and repeatability was assessed using intraclass correlation coefficients (ICCs). A bootstrap method (5000 samples) evaluated the differences in repeatability. Agreement was analyzed using Bland-Altman quantile regression plots, and diagnostic performance was assessed via receiver operating characteristic curves.
Main Outcome Measures:
Measurement accuracy, agreement, and repeatability.
Results:
No significant differences in mean deviation (MD) and pattern standard deviation (PSD) were found between SITA Standard and SITA Faster; however, SPARK Quick demonstrated significantly better MD and PSD (P < 0.001). Test duration was reduced by 57.8% for SITA Faster and 73.8% for SPARK Quick compared to SITA Standard (P < 0.001). Bland-Altman analysis revealed that the mean differences in MD between SITA Standard and SITA Faster and between SITA Standard and SPARK Quick were -0.35 and -3.1, respectively. Intraclass correlation coefficient values indicated excellent repeatability for SITA Faster, whereas SPARK Quick exhibited significantly lower ICCs (P < 0.001). Among the 118 participants, 74 (62.7%) had visual field defects identified by SITA Standard, 72 (61.0%) by SITA Faster, and 31 (26.2%) by SPARK Quick. Sensitivity and specificity for SITA Faster were 83.8% and 77.3%, respectively, compared to 40.5% and 97.7% for SPARK Quick. Receiver operating characteristic analysis yielded area under receiver operating characteristic curves for MD of 0.89 for SITA Faster and 0.86 for SPARK Quick (P = 0.306); for PSD, area under receiver operating characteristic curves were 0.91 and 0.77 (P = 0.005). The Conger's Kappa coefficient indicated fair agreement among the strategies.
Conclusions:
Both SITA Faster and SPARK Quick significantly shorten testing duration. SITA Faster yields results comparable to SITA Standard, while SPARK Quick may underestimate defects.
Financial Disclosure(S):
The authors have no proprietary or commercial interest in any materials discussed in this article.
